A quality-improvement project use of a computerized medical database and reminder letters to increase preventive care...

Previous studies have suggested that preventive health care measures may be improved by proactive patient-reminder systems and use of electronic medical databases.

Our objective was to use Kaiser Permanente's (KP's) electronic medical databases to improve the preventive health care delivered to KP patients in Honolulu, HI.

Patients not seen by their primary care physician in more than one year ("low-utilizing patients") and overdue for preventive health care services were identified using KP's electronic medical databases. These patients were then sent letters requesting that they obtain these services. Response rates and results of their screening tests were tracked.

Of 309 letters sent, 84 (27.2%) patients responded. Of the 260 patients who were reminded of overdue immunizations (tetanus, pneumonia, influenza, or a combination of these), 51 (19.6%) came in to obtain them. Ten of the 37 (27.0%) women overdue for breast cancer screening came in for mammograms. Eleven of the 109 (10.1%) patients overdue for colorectal cancer screening completed fecal occult blood testing.

Outreach letters that target low-utilizing patients identified by an electronic medical database may be an efficient and cost-effective way of improving patient use rates of preventive health care.